BODY ARMOR, WORK INJURIES AND LAW ENFORCEMENT: POLICE OFFICERS, SHERIFFS AND INJURIES DUE TO EQUIPMENT: WHAT YOU NEED TO KNOW

Law Enforcement Officers are required to carry various items as part of their job duties. Equipment, such as Duty Belts, have been recognized as being damaging to the lumbar spine. Due to that fact, the State of California has enacted a Back Injury Presumption for with respect to Law Enforcement Officers who wear duty belts.

Besides Duty Belts, there is other Law Enforcement equipment that has become implicated as to causing physical injury. One of these items is Body Armor. Body Armor has become popular for Law Enforcement to wear to protect them. Body Armor, however, can be physically restrictive. This restrictiveness can be a source of musculoskeletal injury. It should be noted that this Body Armor can be life saving for officers. Police Officers: Surviving a real life-threatening incident while wearing body armor Xiong, Houawa 2014 May URI: https://scholarworks.csustan.edu/handle/011235813/703 (in thesis data, all 24 officers studied survived life-threatening incidents and were able to to return to full duty after the incidents.)

This article will discuss Law Enforcement Officers’ use of Body Armor, the problems with respect to such equipment, and whether it has been found to cause physical problems.

What Is Body Armor?

There are different types of body armor. There is body amor that is designed for military use. Also, there is a different body armor that is designed with respect to Law Enforcement. This different body armor is called Light Armor. The armors of the light variety care called Individual Light Armor Vests or ILAVs.

Are There Any Studies Concerning Light Armor Vests?

Yes. A recent study compared ILVAs versus Normal Station Wear.

What are the Problems with Light Body Armor?

“Wearing body armour has also been found to compromise trunk posture (Phillips et al., 2016) and reduce range of motion in multiple planes (Lenton et al., 2016). Axial trunk rotation has been shown to be reduced by up to 12° when wearing military-styled body armour (Lenton et al., 2016). A generalized increase in trunk and hip forward flexion during tasks has also been associated with wearing body armour (Lenton et al., 2016; Phillips et al., 2015). The effects of both a forward trunk posture and any compromise in trunk or shoulder mobility may further affect an officer’s ability to compensate for any balance compromise and put them at greater risk of falls and subsequent injury (Dempsey et al., 2013).” The effects of body armour on mobility and postural control of police officers Ben Schram Robin Orr Ben Hinton Geoff Norris Rodney Pope https://doi.org/10.1016/j.jbmt.2020.03.001

What Were The Findings of the Study?

The study found “[s]ignificant differences were found between ILAV or N conditions in various components of the FMS, including right Straight Leg Raise, left shoulder mobility, and both right and left quad rotary stability. No significant differences were found in any of the balance measures between these conditions.” Supra.

The conclusions made were that the “ILAVs can significantly affect police officer mobility and therefore may contribute to injury risk and decreased ability to complete occupational tasks, though this should be weighed against protective benefits. ILAVs should therefore be carefully selected to minimise injury risk without detracting from occupational performance.” Supra. [emphasis added]

Are There Any Issues of Controversy with Respect to Body Armor?

Yes. One matter that can become an issue with respect Body Armor is the fact that there are multiple types of body armor which have different styles. There was a study that compared different ILAV and found that there were differences in the comfort and performance. The perceived effects and comfort of various body armour systems on police officers while performing occupational tasks B. Schram1* , B. Hinton2 , R. Orr , R. Pope and G. Norris Schram et al. Annals of Occupational and Environmental Medicine (2018) 30:15 https://doi.org/10.1186/s40557-018-0228-x.

In sum, there are different brands that may have different impacts on the officers wearing them.

What Does Caselaw Say with Respect to Body Armor?

A search review was done with respect to this article. As the writing of this article, there have been no reported cases concerning injury related to the use of body armor. This caselaw search does not reveal as to whether such claims have been made and have been accepted as legitimate injury claims. Rather, the search indicates that there has been no controversy to the point that there has been any noteworthy or reported litigation involving body armor.

What Is the Future?

Many Law Enforcement Departments have received grants and funds to provide body armor to their departments. As a result, there will be more increased use of body armor. This increased use may likely cause musculoskeletal problems which may give rise to a physical injury. This type of physical injury would be the basis for filing a workers’ compensation claim.

What if I Need Advice?

If you would like a free consultation regarding workers’ compensation, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. We have been helping people in Central and Southern California deal with their workers’ compensation cases for 27 years. Contact us today for more information.

CAR WASH WORKERS AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Car Wash Workers have many unique issues with respect to workers’ compensation. Car Wash Workers perform varied tasks which place them at risk for injury. Car Wash Workers are exposed to chemicals and liquids which may place them at risk for injury.

This article will discuss Car Wash Workers and the job tasks that place them at risk for industrial injury.

What Makes Car Wash Workers at Risk for Injury?

“The car wash industry, however, has salient features that predispose to important occupational health risks, namely, the use of hazardous chemicals (ie, hydrofluoric acid), the requirement of repetitive use of extremities, [and] close contact with moving machinery,” Occupational Health of New York City Car Wash Workers Dickens, Brittany BA; Ruiz-Olivo, Laura BA; Palaguachi, Diego BA; Jimenez, David BA; Markowitz, Steven B. MD, DrPH Author Information Journal of Occupational and Environmental Medicine: February 2019 – Volume 61 – Issue 2 – p e77-e79 doi: 10.1097/JOM.0000000000001520

What are the Common Job Tasks Do Workers Perform at Car Washes?

In the study, most participants rotated among the few major tasks at the car wash, including drying cars (63%), brushing and soaping cars (56%), and vacuuming and cleaning cars (50%).
Occupational Health of New York City Car Wash Workers Dickens, Brittany BA; Ruiz-Olivo, Laura BA; Palaguachi, Diego BA; Jimenez, David BA; Markowitz, Steven B. MD, DrPH Author Information Journal of Occupational and Environmental Medicine: February 2019 – Volume 61 – Issue 2 – p e77-e79 doi: 10.1097/JOM.0000000000001520

What Type of Complaints Can Car Wash Workers Have?

In the study, “Car wash workers reported a high prevalence of health symptoms during the 12 months prior to the survey, including at least one site of musculoskeletal pain (80%); upper airway, eye, or skin irritation (71%); and at least one lower respiratory symptom (47%) (Table 2). Approximately one-half of all workers reported eye and throat irritation, back pain, neck or shoulder pain, hand pain, headaches, or nausea/stomach discomfort. The majority of workers reported multiple symptoms across the different symptoms groups. Thirty-eight (54%) participants reported two or more musculoskeletal symptoms in the past 12 months, and 37 (53%) reported two or more types of irritation (nose bleeds, throat irritation, eye irritation/burning, skin rash, or skin burn). Two workers had suffered fractures at work in the past 12 months, and one-quarter of the work force reported a laceration or abrasion of the skin. Three workers reported an episode of asthma or an asthma attack in the past 12 months.” Occupational Health of New York City Car Wash Workers Dickens, Brittany BA; Ruiz-Olivo, Laura BA; Palaguachi, Diego BA; Jimenez, David BA; Markowitz, Steven B. MD, Dr PH Author Information Journal of Occupational and Environmental Medicine: February 2019 – Volume 61 – Issue 2 – p e77-e79 doi: 10.1097/JOM.0000000000001520

What Type of Hand Movements Can Be a Source of Injury?

There are numerous tasks at Car Washes that can be a source of injury. These tasks involve Manual Handling, Awkward Hand Positions, Applying Pressure, and the use of Vibrating Tools.

Manual Handling includes “lifting, pulling, pushing, carrying and holding. Tasks that require these actions can include moving and transporting heavy equipment; everyday machines, such as vacuums; and loads, such as laundry.”

Awkward Hand Position includes “contorting hand posture to abnormal positions to clean hard-to-reach areas or slanted surfaces, such as windows. This would also include risks associated with using older or cheap spray bottles or equipment handles.”

Applying Pressure includes “pressing down or applying extra pressure to remove dirt or soil. Consider more powerful cleaning products or equipment if workers are using too much elbow grease to get the job done.”

The Use of Vibrating Equipment which includes “losing control and constant shaking. Machines that vibrate too much can cause hand fatigue, increasing the chances of workers losing control of the equipment.” . The importance of hand care in the car care industry Rich DiPaolo (2016)

Are There Chemical Exposures That Are Injurious to Car Wash Workers?

Yes. Chemicals used at Car Washes have been implicated in causing occupational illness.

“Exposure to hydrofluoric acid (HF) causes corrosive chemical burns and potentially fatal systemic toxicity. Car and truck wash cleaning products, rust removers, and aluminum brighteners often contain HF because it is efficient in breaking down roadway matter.” Reeb-Whitaker CK, Eckert CM, Anderson NJ, Bonauto DK. Occupational Hydrofluoric Acid Injury from Car and Truck Washing–Washington State, 2001-2013. MMWR Morb Mortal Wkly Rep. 2015;64(32):874-877. doi:10.15585/mmwr.mm6432a4

“Occupational exposure to HF-based wash solutions can result in chemical burns, disability, and death. HF’s potential to cause severe injury.” Supra.

Are Car Wash Employees At Risk for Skin Disorders?

Yes. Cash Wash Employees suffer skin-related due to working with liquids. This type of work is called “wet work.” Zani MLC, Lazzarini R, Silva-Junior JS. W arm-water immersion foot among car wash workers. Rev Bras Med Trab. 2017;15(3):217-221. Published 2017 Sep 1. doi:10.5327/Z1679443520170021

“Wet work is characterized by activities involving frequent immersion of the hands in water, frequent or intensive hand washing or frequent use of impermeable gloves. Workers exposed to wet work might develop hand eczema and contact dermatitis”

Car Washes provide for the risk of both hand skin disorders as well as foot skin disorders. Supra.

“Prolonged contact with water causes different forms of dermatitis, including hand eczema among workers exposed to wet work3. In turn, superficial mycoses are the conditions that most commonly affect the lower limbs. However, continuous and excessive contact with water might also cause a disorder known as immersion foot or trench foot. The latter is a dermatosis that results from prolonged exposure to physical agents such as dampness and cold, and was first described among soldiers in World War I (1914-1918). ”
Supra.

What if I Need Advice?

If you would like a free consultation regarding workers’ compensation, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. We have been helping people in Central and Southern California deal with their workers’ compensation cases for 27 years. Contact us today for more information.

CALIFORNIA FIREFIGHTERS AND WORKERS’ COMPENSATION: FIRE FIGHTERS, WORK INJURIES AND THE MOST RECENT RAND STUDY: WHAT YOU NEED TO KNOW

California Firefighters are tasked with some of the most difficult jobs.   California is perhaps the Forest Fire Capitol of the United States or even the World!  Firefighters provide a vital services in ensuring that we live in safety.

In performing their duties, Firefighters get hurt and have industrial claims.   California Firefighters’ work injuries have been studied by the Rand Corporation and they have prepared a recent report. The study is entitled The Frequency and Economic Impact of Musculoskeletal Disorders for California Firefighters: Trends and Outcomes of the Past Decade, Dworsky, Seabury, and Broten.

This article will address the most recent Rand Corporation Study and what it means to Firefighter and their careers with respect to their work injuries.

What Is the Rand Corporation? What Did It Study?

Rand Corporation is commonly known as a “think tank.”   According to Rand, it “was established over 70 years ago to strengthen public policy through research and analysis. Over seven decades, our research teams have answered the difficult questions and generated actionable insights by combining the very best analytical tools and methods with a distinct, interdisciplinary approach.”  They are frequently used by government, such as the State of California to do research.   The term “public policy” implies that their results can impact laws and proposed legislation.   For our purposes, their conclusions may become the impetus for new changes in workers’ compensation law.

The Rand Corporation Study, with respect to California Firefighters was done with “[t]he purpose of this report was to provide new information to policymakers about the frequency, nature, and consequences of firefighter injuries in California, with a particular focus on MSDs.”  In other words, the State of California may use the data to change workers’ compensation law with respect to Firefighters, or Fire Departments may change their risk management approaches to attempt to reduce claims.

What Did the Rand Study Find?

Highest Rate of Injuries

The Rand Study found that “firefighters are significantly more likely to be injured than workers in other occupations.”

Highest Rate of Musculoskeletal Disorders (MSDs)

The Rand Study found that “ a larger share of those injuries are MSDs.”

Specifically, we found that nearly half (47 percent) of firefighter injuries are MSDs, compared to 38 percent for police officers, 42 percent for other public-sector workers, 37 percent in our private-sector comparison group with similar job requirements to firefighters, and 42 percent for other private-sector workers.

Spine and Knee Injures Are More Common Than Upper Extremity Injuries

The Study found that there were “differences in the nature and cause of firefighter injuries. Compared to other occupations, injuries to firefighters are less likely to involve the upper extremities and significantly more likely to involve lower extremities or the trunk. Strains are the modal cause of injury for firefighters.”

Burn Injuries Are More Significant Than Other Occupations

The Rand Study found that “burns are significantly more common among firefighters than other workers but still represent a small share of injuries (6 percent) in comparison to MSDs.”

Cumulative Trauma vs. Specific Dates of Injury

The Rand Study found that “a lower share of firefighter injuries were reported as being due to cumulative trauma than workers in other occupations.”

Psychiatric Injuries for Firefighters

The Rand Study shows that the dated indicated that “firefighters and police have similar rates of psychiatric comorbidities. However, perhaps surprisingly, incidence rates of psychological injuries—including PTSD—for public safety workers are substantially lower than rates observed among other public-sector workers or comparable private-sector workers.”

Note: as noted in the study, Firefighters may carry with them a stigma concerning mental health issues.   Firefighters with mental health concerns may seek treatment privately rather than file a work injury claim.

Is There Any Good News for Firefighters with respect to the Study?

There was some good news in the Rand Study for Firefighters. The economic consequences of musculoskeletal disorders was less serve than for other similar occupations.   It was noted the Fire Departments appear to do better than other employers, including other public sector employers, at retaining Injured Workers.   Also, SB 863, a recent law change, provided for higher ratings for MSD injuries for Firefighters.  Finally, there was no evidence found that treatment caps for chiropractic, occupational therapy, or physical medicine treatments did not substantially impact most Firefighters.

What is there to Make of the Rand Study?

In light of the findings, it would appear that there would be no effort to try to increase additional indemnity to Firefighters.   Further,  it would appear that there would be no effort to change treatment protocol as well.  Perhaps, injury rate reduction would be explored.   In sum, risk management for the departments may try to take steps to reduce injuries.  Any reduction may be difficult to achieve due to the job’s physical demands.

What if I Need Advice?

If you would like a free consultation regarding workers’ compensation, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. We have been helping people in Central and Southern California deal with their workers’ compensation cases for 27 years. Contact us today for more information.

OIL REFINERY WORKERS AND CARDIOVASCULAR DISEASE:  REFINERY WORKERS, HEART DISEASE AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Oil Refinery Work is unique. Workers at refineries have responsibilities that may place them at risk for cardiovascular disease.  If refinery job responsibilities impact a worker’s cardiovascular health, this industrially caused or aggravated cardiovascular condition is the basis for a workers’ compensation claim. A valid workers’ compensation claim would entitle the Injured Worker to receive medical treatment, compensation in the form of temporary and permanent disability benefits and vocational rehabilitation benefits.

A recent study was conducted with respect to health issues for Refinery Workers. The findings of the study examined the refinery workers’ shifts. See  Carvalho FC, Godinho MR, Ferreira AP. Cardiovascular risk factors among oil refinery workers: ecological study. Rev Bras Med Trab. 2020;18(1):11-19. Published 2020 Aug 4. doi:10.5327/Z1679443520200476

What is Shift Work?

Shift Work is a term that is used for the set hours that employees work. “Shift work is work that takes place on a schedule outside the traditional 9 am – 5 pm day. It can involve evening or night shifts, early morning shifts, and rotating shifts. Many industries rely heavily on shift work, and millions of people work in jobs that require shift schedules.” https://www.sleepfoundation.org/shift-work-disorder/what-shift-work

With respect to refineries, there are number of these facilities that require shift work.

Are There Health Risks With Shift Work?

“Several studies sought to identify such factors in different groups of people10,18,19,20,21, and shiftwork was found to contribute to serious physical, mental and/or social problems.” Carvalho FC, Godinho MR, Ferreira AP. Cardiovascular risk factors among oil refinery workers: ecological study. Rev Bras Med Trab. 2020;18(1):11-19. Published 2020 Aug 4. doi:10.5327/Z1679443520200476.

“Shift work can also affect workers’ quality and length of life by making them more prone to various disorders, including cardiovascular disease.” https://www.sleepfoundation.org/shift-work-disorder/what-shift-work

What are Cardiovascular System Diseases?

The Cardiovascular System Diseases many medical conditions. These include acute myocardial infarction, angina, arrythmias, congestive heart failure, coronary artery disease, hypertension, and valvular heart disease.

Note: Not all cardiovascular disease may have an industrial contribution.  Medical Analysis and Medical Expert Witness Opinion is required to make such a determination.

What Was the Shift Work That Was Subject to the Study?

In the study, “[e]mployees with fixed schedule work Monday to Friday from 7:30 to 16:30, being off duty on weekends and holidays to a total of 40 hours/week. Shiftwork was implemented to ensure uninterrupted operation, through five rotational teams under three 8-hour shifts – 7:00 to 15:00, 15:00 to 23:00 and 23:00 to 7:00 – all seven days of the week, including holidays, with rest between shifts, to a total working time of 32 hours/week. These workers receive additional pay. The work/rest schedule was approved by the corresponding trade union and complies with the labor laws in force.” Carvalho FC, Godinho MR, Ferreira AP. Cardiovascular risk factors among oil refinery workers: ecological study. Rev Bras Med Trab. 2020;18(1):11-19. Published 2020 Aug 4. doi:10.5327/Z1679443520200476

What Were the Findings of This Study?

The study found that

“[t]he highest odds of hypertension and high LDL corresponded to men above 40 and shift workers.

The highest odds of diabetes were exhibited by workers above 40 and those with fixed work schedule independently from sex. Risk of CVD was moderate, despite young age, high educational level and available resources at the company.

The results further indicated a high rate of employees exposed to three or more risk factors, whence one may infer a need for multiple interventions. Carvalho FC, Godinho MR, Ferreira AP. Cardiovascular risk factors among oil refinery workers: ecological study. Rev Bras Med Trab. 2020;18(1):11-19. Published 2020 Aug 4. doi:10.5327/Z1679443520200476

Thus we found higher prevalence of hypertension and high LDL among shift workers compared to employees with fixed work schedule. Carvalho FC, Godinho MR, Ferreira AP. Cardiovascular risk factors among oil refinery workers: ecological study. Rev Bras Med Trab. 2020;18(1):11-19. Published 2020 Aug 4. doi:10.5327/Z1679443520200476 [emphasis added]

I am a Refinery Worker, What Does This Mean?

Performing shift work may have an impact on your cardiovascular health. If you work at a refinery, perform shift work, and are having cardiovascular system issues, it may be in your interest to consider whether it is in your interest to pursue a workers’ compensation claim.

What If I Need Advice? 

If you would like a free consultation concerning any workers’ compensation case, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. They have been helping people in Central and Southern California deal with their worker’s compensation cases for 28 years. Contact us today for more information.

 

ALTERED MEDICAL STATES (AMS) AND WORKERS’ COMPENSATION: INJURED WORKERS, MENTAL STATUS, AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Altered Medical States (AMS) is a medical condition of import within the Workers’ Compensation System.  Irrespective of whether the Injured Worker’s AMS is work-related or not, the fact that an Injured Worker has such a condition which may impact their ability to communicate and their ability to understand is of concern.

Workers’ Compensation is a medical-legal system.   An Injured Workers with an altered medical state raise both medical and legal concerns.  The Workers’ Compensation System requires Injured Workers to provide truthful and accurate information.   The System also allows for Injured Workers to enter into binding contracts and agreements.   Therefore, an Injured Worker’s mental state is important.

This article will discuss Altered Medical States, how Altered Medical States can impact medical treatment and reporting,  and how Altered Medical States can impact Workers’ Compensation Litigation.

What is an Altered Medical State?

Altered Medical State can range from “total loss of consciousness to extreme excitation.” Evaluation and treatment of altered mental status patients in the emergency department: Life in the fast lane Hai-yu XiaoYu-xuan WangTeng-da XuHua-dong ZhuShu-bin GuoZhong Wang, and Xue-zhong Yu World J Emerg Med. 2012; 3(4): 270–277 doi: 10.5847/wjem.j.issn.1920-8642.2012.04.006 PMCID: PMC4129809 PMID: 25215076

Altered Medical States include central nervous system inhibition which can include coma, drowsiness, and confusion.   It can include central nervous system stimulation including irritability and aggressiveness. It can include “abnormal behavior.” Supra.

What Are the Medical Causes of Altered Medical States?

There are many reasons as to why someone may have an Altered Medical State.  Many of these AMS conditions can be work-related.  Medical Causes of AMS include both Neurological and Non-Neurological Causes.

AMS causes differ based upon based upon age. Top causes of AMS for elderly patients can include cerebrovascular disease, systemic or organic failure and infection.   Top causes for non-elderly are drugs and toxic factors, systemic and organic failure, and metabolic and endocrine disorders.  Supra.

Various causes of AMS can include drugs and substance intoxication, infection, metabolic endocrine abnormalities, trauma, cancer, and system/organ dysfunction.  This can include acute alcoholism. It can also be caused by trauma, i.e. head trauma, and infection. Supra.

What are the Workers’ Compensation Concerns with respect to Injured Workers with AMS?

With respect to the Workers’ Compensation Claim, an Injured Worker with an altered medical state can have problems with respect to the medical-legal reporting to support the claim of injury.   If the work injury caused an altered medical state, then there is a likelihood that the immediate medical treatment may not have an accurate history as to how the injury/medical condition was work-related.    For example, there are times when an Injured Workers are found unconscious and is then sent for medical treatment.   In those circumstances, the initial medical providers may not be able to document any information that can support the work injury.

Altered Medical States can also be when an Injured Worker is attending workers’ compensation related medical appointments.   Injured Workers may be taking prescription medications that impact their abilities to comprehend and answer questions posed by medical providers.   This again can impact the quality of the medical-legal reporting as to both the history of injury and ongoing complaints.

An individual may be so intoxicated that evaluations may be terminated.   This problem does not only relate to prescription medications.   Injured Workers may consume alcohol or take street drugs that may impact their mental state.

In sum, there can be work-related and non-work related AMS issues which impact medical treatment and medical-legal reporting.

Additionally, there are some Injured Workers that suffer from severe mental health issues where they have problems being communicative.   Further, these Injured Workers may have such problems where the evaluators have serious doubt as to whether they can provide accurate information.

What are the Legal Concerns of Altered Medical States?

The Workers’ Compensation System is a legal system and statements made by Injured Workers are placed under a legal microscope.   False Statements can lead to allegations of Workers’ Compensation Fraud.   Criminal penalties can apply.

Thus, there is a concern as to whether an Injured Worker with an altered medical state is capable to speaking the truth.   For example, if the Injured Worker is having hallucinations, there may be some question as to whether they know what they are doing and saying.  Additionally, an Injured Worker may be taking medications when they are having their deposition taken.   The medications may impact on their ability to understand and answer questions in a truthful fashion.

Thus, if an Injured Worker has AMS issues, it is important that AMS be documented.  It may be needed to address accusation so fraud.  Note: there are three times in which reporting may be required: medical examinations and evaluations, the Injured Worker’s deposition, and the Injured Worker’s trial.

What Should Be Done with Respect to Injured Workers with AMS? Temporary versus Permanent AMS?

If an Injured Worker has a permanent AMS state, the use of a Guardian Ad Litem is indicated.   In other words, a trusted person, i.e. parent or spouse, should be appointed by the Workers’ Compensation Appeals Board to make decisions with respect to the case.

If the Injured Worker has a temporary AMS state, the parties should all take careful consideration that the Injured Worker is understanding what is going on and is making their decisions and statements in an unaltered state.   If there is some settlement, the fact that the individual is capable of entering into the agreement should be documented.

What If I Need Legal Advice?

If you would like a free consultation concerning any workers’ compensation case, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. They have been helping people in Central and Southern California deal with their worker’s compensation cases for 28 years. Contact us today for more information.

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